Brief interventions for heavy alcohol users admitted to general hospital wards

McQueen, Jean; Howe, Tracey; Allan, Linda; Mains, Diane; Hardy, Victoria

doi:10.1002/14651858.cd005191.pub3

Cited by 185 publications

(139 citation statements)

References 73 publications

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“…These results concur with those presented in a systematic review of ABI in a general hospital setting, confirming the effectiveness of ABI in reducing alcohol consumption (McQueen et al, 2011). The systematic review of 14 studies indicates that patients receiving brief interventions have a greater reduction in alcohol consumption compared with those in control groups at 6-and 9-month follow-ups.…”

Section: Discussionsupporting

confidence: 86%

“…However, the small number of studies, relatively small sample sizes, and heterogeneity between the studies resulted in large confidence intervals and less certainty as to the true effects of ABI. This systematic review identified the need for more studies within general hospital settings (McQueen et al, 2011). Synergies between the findings are reassuring, and future updates of the systematic reviewincluding newly published studies such as this one-will add to the evidence base.…”

Section: Discussionmentioning

confidence: 77%

“…The attrition rate was correct because 70% of the participants were followed up 6 months later. This compares with retention rates of between 68% and 100% in the 14 studies included in the systematic review of ABI in general hospital settings (McQueen et al, 2011). A further strength of this study is that an intention-to-treat analysis was used.…”

Section: Discussionmentioning

confidence: 80%

“…The first study into ABI in general hospitals observed improvements in self-reported problems related to alcohol but not alcohol consumption (Chick et al, 1985). A systematic review of ABI in general hospitals included 14 studies with 4,041 participants and identified the need for further research on the optimal content and treatment exposure for ABI (McQueen et al, 2011).…”

mentioning

confidence: 99%

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Effectiveness of Alcohol Brief Intervention in a General Hospital: A Randomized Controlled Trial

McQueen

Howe

Ballinger

et al. 2015

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: The purpose of this study was to examine the effectiveness of an alcohol brief intervention (ABI) on alcohol consumption in hazardous or harmful drinkers compared with screening alone within a general hospital setting. Method: Following screening, 124 hazardous or harmful drinkers (103 men, ages 18-80 years, score of 3-12 on the Fast Alcohol Screening Test [FAST]) admitted to medical and orthopedic wards during the 13-month recruitment period were randomized to receive an ABI or control. The intervention group received an ABI where they were supported to set their own personalized alcohol reduction goals, and both groups received a health information leaflet. Retrospective alcohol consumption for 7 days was reported for the week, before hospital admission and 6 months after it. Results: Demographics and clinical characteristics at baseline showed no statistical differences between the two groups on all variables except FAST score, which was higher in the intervention group (p ≤ .05). A reduction of 85 grams of alcohol per week (95% CI [162.46, 7.54]) was observed between groups in favor of the intervention group based on changes from baseline. However, there was no significant difference between groups for absolute grams of alcohol per week at 6 months. A significant mean difference in favor of the intervention group (U = 1,537, p = .043) was observed for weekly heavy drinking episodes. Conclusions: Our results suggest screening with delivery of ABI for harmful/hazardous drinkers in a general hospital is beneficial in reducing alcohol consumption compared with screening alone. (J. Stud. Alcohol Drugs, 76, 838-844, 2015)

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 80%

mentioning

confidence: 99%

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Effectiveness of Alcohol Brief Intervention in a General Hospital: A Randomized Controlled Trial

McQueen

Howe

Ballinger

et al. 2015

J. Stud. Alcohol Drugs

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“…This figure is substantially higher than the 33% reported in general practices in their study. Bischof et al (2010) are correct that the number of risky drinkers in hospitals is high, and there may be opportunity to intervene, although studies in these settings have been inconclusive, and severity may be part of the explanation, though efficacy has yet to be proven even among those without dependence (Freyer-Adam et al 2008;McQueen et al 2009). The literature to date is clear that the majority of patients identified by alcohol screening in hospitals have more severe unhealthy use (an alcohol disorder) than in general practice settings where alcohol brief intervention is known to have efficacy for those without dependence.…”

mentioning

confidence: 99%

Most inpatients with unhealthy alcohol use have an alcohol use disorder

Saitz

2010

Int J Public Health

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Outcomes After Initiation of Medications for Alcohol Use Disorder at Hospital Discharge

Bernstein,

Baggett,

Trivedi

et al. 2024

JAMA Netw Open

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ImportanceUS Food and Drug Administration–approved medications for alcohol use disorder (MAUD) are significantly underused. Hospitalizations may provide an unmet opportunity to initiate MAUD, but few studies have examined clinical outcomes of patients who initiate these medications at hospital discharge.ObjectiveTo investigate the association between discharge MAUD initiation and 30-day posthospitalization outcomes.Design, Setting, and ParticipantsThis cohort study was conducted among patients with Medicare Part D who had alcohol-related hospitalizations in 2016. Data were analyzed from October 2022 to December 2023.ExposuresDischarge MAUD initiation was defined as oral naltrexone, acamprosate, or disulfiram pharmacy fills within 2 days of discharge.Main outcomesThe primary outcome was a composite of all-cause mortality or return to hospital (emergency department visits and hospital readmissions) within 30 days of discharge. Secondary outcomes included these components separately, return to hospital for alcohol-related diagnoses, and primary care or mental health follow-up within 30 days of discharge. Propensity score 3:1 matching and modified Poisson regressions were used to compare outcomes between patients who received and did not receive discharge MAUD.ResultsThere were 6794 unique individuals representing 9834 alcohol-related hospitalizations (median [IQR] age, 54 [46-62] years; 3205 hospitalizations among females [32.6%]; 1754 hospitalizations among Black [17.8%], 712 hospitalizations among Hispanic [7.2%], and 7060 hospitalizations among White [71.8%] patients). Of these, 192 hospitalizations (2.0%) involved discharge MAUD initiation. After propensity matching, discharge MAUD initiation was associated with a 42% decreased incidence of the primary outcome (incident rate ratio, 0.58 [95% CI, 0.45 to 0.76]; absolute risk difference, −0.18 [95% CI, −0.26 to −0.11]). These findings were consistent among secondary outcomes (eg, incident rate ratio for all-cause return to hospital, 0.56 [95% CI, 0.43 to 0.73]) except for mortality, which was rare in both groups (incident rate ratio, 3.00 [95% CI, 0.42 to 21.22]). Discharge MAUD initiation was associated with a 51% decreased incidence of alcohol-related return to hospital (incident rate ratio, 0.49 [95% CI, 0.34 to 0.71]; absolute risk difference, −0.15 [95% CI, −0.22 to −0.09]).Conclusion and relevanceIn this cohort study, discharge initiation of MAUD after alcohol-related hospitalization was associated with a large absolute reduction in return to hospital within 30 days. These findings support efforts to increase uptake of MAUD initiation at hospital discharge.

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Brief interventions for heavy alcohol users admitted to general hospital wards

Cited by 185 publications

References 73 publications

Effectiveness of Alcohol Brief Intervention in a General Hospital: A Randomized Controlled Trial

Effectiveness of Alcohol Brief Intervention in a General Hospital: A Randomized Controlled Trial

Most inpatients with unhealthy alcohol use have an alcohol use disorder

Outcomes After Initiation of Medications for Alcohol Use Disorder at Hospital Discharge

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